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Brandeis University
2022-2023 Noncustodial Parent Information Waiver Petition
Student Name: Date of Birth:
Instructions
Brandeis University requires financial information from both natural parents to determine a student’s financial aid eligibility. This
form is only to be submitted if you cannot obtain your CSS Noncustodial Parent Financial Aid PROFILE. If
you have no contact with
your noncustodial parent, you may request to waive this requirement.
Once the Student Financial Services Appeals Committee
reviews the submitted Petition, we will notify the student by mail. You should expect a response within 5-10 business days based on
our volume of appeals at the time you submit your request and your admissions and financial aid application status. Submission of this
application does not guarantee that your request will be approved.
Based on the information provided in the Petition, we may require additional documentation, such as a written statement from a third
party. Typically, these letters come from counselors, ministers and other professionals close to a student’s situation.
Types of waiver requests that may be considered:
Documented abuse situations with your noncustodial parent.
Legal orders that limit the noncustodial parent's contact with the student.
No
contact or support ever received from the noncustodial parent.
Examples of documents that may be required:
Court documents or legal orders, as available.
Third-party documentation - a written statement or letter from a counselor, a social
worker, a teacher, or clergy who can
certify to your situation. Statements from
family members, family friends, or attorneys will not be accepted.
Types of waiver requests that will not be considered:
Noncustodial parent refuses to complete the form and/or contribute towards college expenses.
Divorce decree states that the noncustodial parent is not responsible for the student's
educational expenses.
If you have any questions, please contact our office at 781-736-3700 or sfs@brandeis.edu.
The completed Noncustodial Parent Waiver Petition and all
Office of Student Financial Services
applicable supporting documentation should be submitted to:
Brandeis University
415 South Street, MS 027
Waltham, MA 02454-9110
FAX: 781-736-3719
EMAIL: finaid@brandeis.edu
Part I – Noncustodial Parent Information
Noncustodial Parent Name: Occupation:
Permanent Address: Telep
hone Number:
Email Address:
Marital Status of your natural parents Separated/Divorced Never Ma
rried
If separated/divorced, indicate the year of separation and divorce: Separation Date:
Divorce Date:
Has your noncustod
ial parent ever claimed you as a dependent on a federal tax return? YES NO
If yes, indicate the most recent tax year th
at this occurred:
1 of 2
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Part II - Frequency of Contact
Have you had contact with your noncust
odial parent in the past year? YES NO
If yes, how many times were you in
contact?
What was the nature of contact (i.e. visit, phone call, email, etc.)?
If no, indicate the date of your last contact with him/her?
Are there legal orde
rs that limit your noncustodial parent’s contact with you? YES NO
If yes, please attach documentation (i.e. restrai
ning order, police report or divorce decree).
Will/did this parent attend your high school graduation?
YES NO
Do you expect this parent to attend your college graduation?
YES NO
Part III – Child Support Information
Did your noncustodial parent pay child support in 2020? YES NO
If yes, indicate the total amount he/she paid for you:
For other children in yo
ur household:
If no, indicate the last
year he/she paid child support:
Did your noncustodial parent pay child support in 2021?
YES NO
If yes, indicate the total amount he/she paid for you:
Fo
r other children in your household:
If no, indicate the last year he/she paid child support:
Part IV – Additional Information **REQUIRED**
Please provide an explanation of your circumstances that will help us to better understand why you believe it would be appropriate for
us to waive any financial information or contribution from your noncustodial parent. Be sure to provide as much detail as possible in
an attached letter.
Part V – Supporting Documentation
Indicate which supporting documentation you have included:
Third party documentation – a written statement or letter from a counselor, a social
worker, a teacher, or clergy who
can certify to your situation. Statements from family
members, family friends, or attorneys will not be accepted.
Copy of police report or restraining order.
Other documents (list):
Part VI - Certification
The information provided on this form is accurate and complete to the best of our knowledge. We agree to notify Student Financial
Services if our information about or situation with the noncustodial parent changes.
Student’s Signature: Date:
Parent’s Signatu
re: Date:
2 of 2
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Completed 7 February 2022

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